Eli Lilly will limit the out-of-pocket cost of his insulin to $35 a month, the drugmaker said Wednesday. The move, experts say, could prompt other insulin makers in the US to follow suit.
The change, which Eli Lilly said is effective immediately, brings the drugmaker in line with a provision of the Inflation Reduction Act, which last month imposed a $35 monthly cap on the out-of-pocket cost of insulin for seniors enrolled in Medicare.
Insulin manufacturers continue to face pressure from members of Congress and advocacy groups to lower the cost of life-saving drugs. Insulin costs in the US are notoriously high compared to costs in other countries; The RAND Corporation, a public policy think tank, estimated that in 2018, the average list price of a vial of insulin in the US was $98.70.
The limit is automatically applied to people with private insurance. Uninsured individuals will be eligible as long as they enroll in Eli Lilly’s co-pay assistance program.
That program began providing insulin to patients, regardless of their insurance status, for no more than $35/mo in 2020 due to the Covid pandemic.
The limit applies to all Eli Lilly insulin products, said Kelly Smith, a company spokeswoman. In addition to cost caps, the company will lower the list price of several of its products, including Humalog, this year.
About 8.4 million people with diabetes in the US are insulin dependent, according to the American Diabetes Association. Three drugmakers, Eli Lilly, Novo Nordisk, and Sanofi, dominate the insulin market.
Three out of 10 people with insulin-dependent diabetes use an Eli Lilly product, Smith said.
In November, Eli Lilly’s stock price fell sharply after a fake tweet from an impostor account falsely claimed the company was making insulin without insulin, renewing focus on its cost.
In addition to political pressure, Eli Lilly also faces the threat of competition from outside the industry, said Larry Levitt, executive vice president for health policy at KFF, formerly known as the Kaiser Family Foundation.
Civica Rx, a nonprofit company in Lehi, Utah, said last year that it plans to manufacture and sell generic versions of insulin to consumers for no more than $30 per vial and no more than $55 for a box of five pen cartridges. . The state of California also plans to make low-cost insulin, as does Mark Cuban Cost Plus Drug Co., which sells low-cost drugs online.
“Eli Lilly definitely sees the writing on the wall,” Levitt said.
Stacie Dusetzina, a professor of health policy at Vanderbilt University Medical Center in Nashville, Tennessee, agreed that the move was likely driven by increased competition.
“The company is reacting to an enormous amount of existing and future competition for these drugs,” he said.